Factors Associated with Non-Attendance at a Hand Surgery Appointment

Abstract

Background

Patients who miss scheduled appointments without notifying office staff—“no-shows”—disrupt practice workflow and decrease access for others, resulting in misuse of resources and lost revenue. The primary purpose of this study was to identify factors associated with no-shows in a hospital-based outpatient hand office. Secondarily, we studied factors associated with cancelations.

Methods

Of the 14,793 new adult patient appointments to our outpatient hand surgery office scheduled between January 2011 and December 2013, 880 (5.9 %) were no-shows and 2715 (18 %) were cancelations. Data on patient demographics and timing of the visit were collected to construct a multinomial logistic regression model of determinants of appointment no-shows and cancelations.

Results

Factors independently associated with no-shows included younger age, Hispanic or black race, unmarried status (single or divorced), appointment on a Monday or Tuesday, and residence near the office. Factors associated with cancelations were female sex, unmarried status (widowed or divorced), winter season, and appointment on a weekday other than Friday.

Conclusions

Non-attendees are more likely to be younger, unmarried, non-white, to have their appointments at the start of the week, and to live near the office. Knowledge of these factors might prove useful for implementation of tailored quality improvement initiatives to reduce non-attendance and maximize productivity in the hand surgery office setting.

Type of study/level of evidence: Prognostic IV.

Keywords

Appointments No-shows Cancelations Hand surgery

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References

1 Adams

Pawlik

Forbes

. Nonattendance at outpatient endoscopy. Endoscopy. 2004;36(5):402–4.

2 Bliss

Katz

Wright

. Estimating proximity to care: are straight line and zipcode centroid distances acceptable proxy measures? Med Care. 2012;50(1):99–106.

3 Clarke

Soneji

. Rates and risk factors for prolonged opioid use after major surgery: population based cohort study. BMJ. 2014;348:g1251.

4 Cohen

Goldbart

Levi

. Health provider factors associated with nonattendance in pediatric dermatology ambulatory patients. Pediatr Dermatol. 2007;24(2):113–7.

5 Cohen

Kaplan

Kraus

. Nonattendance of adult otolaryngology patients for scheduled appointments. J Laryngol Otol. 2007;121(3):258–61.

6 Cohen

Kaplan

Shapiro

. Health provider determinants of nonattendance in pediatric otolaryngology patients. Laryngoscope. 2005;115(10):1804–8.

7 Collins

Santamaria

Clayton

. Why outpatients fail to attend their scheduled appointments: a prospective comparison of differences between attenders and non-attenders. Aust Health Rev. 2003;26(1):52–63.

8 Cosgrove

. Defaulters in general practice: reasons for default and patterns of attendance. Br J Gen Pract. 1990;40(331):50–2.

9 Cronin

DeCoste

Kimball

. A multivariate analysis of dermatology missed appointment predictors. JAMA Dermatol. 2013;149(12):1435–7.

10.

10 Deyo

Inui

. Dropouts and broken appointments. A literature review and agenda for future research. Med Care. 1980;18(11):1146–57.

11.

11 Dreiher

Froimovici

Bibi

. Nonattendance in obstetrics and gynecology patients. Gynecol Obstet Invest. 2008;66(1):40–3.

12.

12 Dreiher

Goldbart

Hershkovich

. Factors associated with non-attendance at pediatric allergy clinics. Pediatr Allergy Immunol. 2008;19(6):559–63.

13.

13 Ellis

Jenkins

. Weekday affects attendance rate for medical appointments: large-scale data analysis and implications. PLoS One. 2012;7(12):e51365.

14.

14 Feitsma

Popping

Jansen

. No-show at a forensic psychiatric outpatient clinic: risk factors and reasons. Int J Offender Ther Comp Criminol. 2012;56(1):96–112.

15.

15 Giunta

Briatore

Baum

. Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital. Patient Prefer Adherence. 2013;7:1163–70.

16.

16 Goldman

Freidin

Cook

. A multivariate approach to the prediction of no-show behavior in a primary care center. Arch Intern Med. 1982;142(3):563–7.

17.

17 Goodhart

Kramer

Zaidi

. Characteristics of defaulters in treatment for infection with Neisseria gonorrhoeae. J Infect Dis. 1979;140(4):649–51.

18.

18 Grover

Gagnon

Flegel

. Improving appointment-keeping by patients new to a hospital medical clinic with telephone or mailed reminders. Can Med Assoc J. 1983;129(10):1101–3.

19.

19 Hamilton

Round

Sharp

. Patient, hospital, and general practitioner characteristics associated with non-attendance: a cohort study. Br J Gen Pract. 2002;52(477):317–9.

20.

20 Kruse

Rohland

. Factors associated with missed first appointments at a psychiatric clinic. Psychiatr Serv. 2002;53(9):1173–6.

21.

21 Lacy

Paulman

Reuter

. Why we don't come: patient perceptions on no-shows. Ann Fam Med. 2004;2(6):541–5.

22.

22 Lawson

Lyne

Harvey

. Understanding why people with type 1 diabetes do not attend for specialist advice: a qualitative analysis of the views of people with insulin-dependent diabetes who do not attend diabetes clinic. J Health Psychol. 2005;10(3):409–23.

23.

23 Lloyd

Bradford

Webb

. Non-attendance at outpatient clinics: is it related to the referral process? Fam Pract. 1993;10(2): 111–7.

24.

24 Molfenter

. Reducing appointment no-shows: going from theory to practice. Subst Use Misuse. 2013;48(9):743–9.

25.

25 Neal

Hussain-Gambles

Allgar

. Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records. BMC Fam Pract. 2005;6:47.

26.

26 Neal

Lawlor

Allgar

. Missed appointments in general practice: retrospective data analysis from four practices. Br J Gen Pract. 2001;51(471):830–2.

27.

27 Oppenheim

Bergman

English

. Failed appointments: a review. J Fam Pract. 1979;8(4):789–96.

28.

28 Parikh

Gupta

Wilson

. The effectiveness of outpatient appointment reminder systems in reducing no-show rates. Am J Med. 2010;123(6):542–8.

29.

29 Penneys

Glaser

. The incidence of cancellation and nonattendance at a dermatology clinic. J Am Acad Dermatol. 1999;40(5 Pt 1):714–8.

30.

30 Sharp

Hamilton

. Non-attendance at general practices and outpatient clinics. BMJ. 2001;323(7321):1081–2.

31.

31 Stone

Palmer

Saxby

. Reducing non-attendance at outpatient clinics. J R Soc Med. 1999;92(3):114–8.

32.

32 Ten Berg

Ring

. Patients lost to follow-up after metacarpal fractures. J Hand Surg [Am]. 2012;37(1):42–6.

33.

33 Tugade

Fredrickson

. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol. 2004;86(2):320–33.

34.

34 Zirkle

McNelles

. Nonattendance at a hospital-based otolaryngology clinic: a preliminary analysis within a universal healthcare system. Ear Nose Throat J. 2011;90(8):E32–4.